Slow weight gain, need help!!

Ok I was wondering if there is anything to make my milk more "nutritional"? I EBF my DD2, (third child) but she is slowly gaining weight! Gained about 6-7 oz in 12 days! I don't think it's a supply issue because my DD2 chokes on it at times!! I don't think the choking is due to forceful letdown because it happens well into a feeding!! I am trying my hardest to make it to at least 6 months because my first child I nursed 5 weeks had issues and quit!! My second was considered failure to thrive and I quit nursing at 7 weeks!!! I really want a success story but not sure how to accomplish that and keep my DD2 healthy!!! Please help!!!

Re: Slow weight gain, need help!!

Welcome to the forum!

When there is an issue with an EBF baby's weight gain, the problem is almost always the quantity of milk the baby is getting, not the quality (i.e., the amount of calories in the milk). So there's no reason to worry about how to enhance the "nutritional" nature of your milk. Instead, let's talk breastfeeding basics, and see if we can spot what's going on. So, some questions for you:
- How old is your baby?
- Can you post a complete weight history, including birth weight, lowest known weight, and weight at each checkup?
- Has baby always been weighed following proper procedure, that is, in the nude or in a dry díaper only, using a digital scale, and using the same scale every time?
- How many times does your baby nurse in a 24 hour period?
- How does nursing feel?
- Is baby particularly sleepy or jaundiced?
- What is the average nursing session like? (How long does it last, does the baby take one breast or both, does the baby rapidly doze off and need to be woken, etc.)
- Has the baby been carefully checked for tongue and lip ties?

Re: Slow weight gain, need help!!

Ok a little back story!! I had a pituitary tumor that told my body I was pregnant!! No periods, lactating, the works! I was put on melds to stop lactation and shrink the tumor! It took 2 1/2 years to get pregnant with my DD1 almost nine years ago with fertility treatments!! Then 2 years later, after still no periods, I got pregnant with my DS!! Now almost 7 years later I have my DD2! At birth she was 7lbs 5oz, at 3 days old on discharge from hospital she was 6lbs 11oz! Day 5 she was 6lbs 10oz! Day 7 she was back to 6lbs 11oz! Day 17 she was 7lbs 2oz!! All same scale at pediatricians office, stripped naked!! She was jaundiced and almost hospitalized on day 6 but was rechecked thru venipuncture instead of heel prick and was not quite high enough to admit!! As of day 17 pediatrician said she's still a little jaundiced! Tomorrow she will be 21 days old! She nurses at least every 2-3 hours, we went thru cluster feeds, still does sometimes! Most of the time the nursing session is about 25 mins! I always nurse from one breast to make sure it is emptied! And I don't think she has been checked for tongue or lip ties! The LC's in the hospital said latch and everything was great!! Just confused and trying to have a successfully nursed baby!! Thank you in advance for all your input!!!

Re: Slow weight gain, need help!!

I hope mommal does not mind if I jump in as I am on here right now.

3 week old babies typically need to nurse at least 10-12 times in a 24 hour day. Often they nurse more often than that. So my first suggestion would be to encourage more frequent nursing. If baby is being swaddled or given a pacifier or spending longish mounts of time in a room separately from where you are, either stop those practices or reduce them.

There is no reason to nurse from one side at a time to make sure the breast gets emptied. This is fine of that is all baby wants and weight gain is good, but is probably not a great idea if weight gain is slow. If baby indicates she wants the other side, or is 'slowing down' and being less active with her sucking or swallowing, or getting sleepy, I would suggest try switching baby to the other side. This can even be done more than once per feeding if you and baby like. This not only usually helps get more into baby more quickly, it is a pretty good way to increase milk production should that be needed. Breast compressions can also be helpful with issues of slow gain: http://www.breastfeedinginc.ca/conte...agename=doc-BC

As of day 17 pediatrician said she's still a little jaundiced

Was this confirmed with testing and are the levels lower than before or not? It sometimes takes time for the numbers to go down so more testing may be needed to make sure they are indeed going down. Also, jaundice usually makes baby sleepy and consequently baby may nurse less. Were you/are you needing to wake baby to nurse?

All same scale at pediatricians office, stripped naked!!

But not birth weight, or the discharge done in hospital- right? Scale differences make for inaccurate measures.

At birth she was 7lbs 5oz, at 3 days old on discharge from hospital she was 6lbs 11oz! Day 5 she was 6lbs 10oz! Day 7 she was back to 6lbs 11oz! Day 17 she was 7lbs 2oz!!

So initial weight loss of 10 ounces would typically be at the high end of the normal range of 5-10% of your baby's birth weight. In any case, I would suggest do not worry about birth weight at this point and from now on measure gain from lowest known weight- the day 5 weight check.

Baby weighed 6 lbs 10 ounces at age 5 days. Between day 5 and day 17, (12 days) baby gained 7 ounces. This IS slow gain, but clearly baby IS gaining. Gain of about an ounce a day (Averaged over some time- not exactly an ounce each day) is considered good weight gain. But not all healthy, normally gaining babies gain this quickly. Since day 5, your baby gained an average of .58 ounces per day- slightly over 1/2 ounce. I would agree that getting that higher asap makes sense, and that is why I made the above suggestions. But it is not as if baby is starving or in danger at this point, (unless the jaundice numbers are dangerously high) because baby is gaining.

Is baby overtly sleepy or overtly fussy? And how many times in 24 hours does baby typically poop, how much is it, and what does it look like?

Also, what did the doctor say at the 17 day weight check? Were supplements ordered? Light therapy? Is another weight check scheduled? Are you able to see an IBCLC to have breastfeeding assessed?

Re: Slow weight gain, need help!!

Jaundice hasn't been checked again since day 7! Baby wakes on her own usually 2 hour intervals!! Fussy, gassy, spits up, chokes on milk while nursing! She would not latch on in the hospital close to discharge and the first day home, I had to use a syringe with sugar water to get her to latch then even that quit working!! Finally I figured out that she needs a clean diaper to nurse! So with that said, there is at least a squirt of yellow poop in each diaper b4 each feeding 99% of the time! Sometimes more than just a squirt!! When she was really bad jaundiced, the dr wanted me to give formula, I tried one oz after I nursed once and within 5 mins that was spit up!! So I haven't tried or been told to again!! I am scheduled for another weight check on Thursday which will put her at 24 days old! Also didn't really say anything about the jaundice, just mentioned she still looked a lil jaundiced!

Re: Slow weight gain, need help!!

What sort of tumor was it- was it a prolactinoma? If so, you may want to take a trip to the endocrinologist to verify that your body is still capable of producing a normal amount of prolactin. Given that you seem to be feeling like you have some overproduction going on, this does not seem like a major worry, but I'd still want to see the doc. Especially given that your first 2 breastfeeding experiences went awry.

So baby nurses every two hours, night and day, for a total of 12 nursing sessions in 24 hours? That is usually going to be enough, but since baby is still not gaining well enough, do you think you can encourage baby to nurse slightly more often at least some of the time? Even one or two more nursing sessions a day can make the difference between slow gain and normal gain. What about the other ideas I suggested like switching sides?

As far as baby choking, as mommal notes that is consistent with overproduction. But slow weight gain certainly is not...I think that baby having a hard time with normal milk flow would also be a sign that baby is not or can not latch entirely effectively. I also think that if you are nursing one sided each session, that may be contributing to a fast letdown that might cause the choking.

Spit up is usually normal and not a factor in poor gain, but if baby is not gaining well and spitting up very forcefully, it is important that pyloric stenosis is ruled out.

Re: Slow weight gain, need help!!

In response to maddieb, I don't think pyloric stenosis is the problem! My nephew had that when he was a baby and the spitting up is not as bad as his was!! I don't think the choking is due to letdown for the reason that she will sometimes choke towards the end of a nursing session! Like at the 20-25 min mark! It is just very discouraging sometimes!!! I sometimes just want to give up!! Since it didn't work neither of the other times, I just have the thought that it's not gonna work this time and giving up is so much easier to pop in my mind!! I have a bad mental battle with wanting a success story and wanting to give up!!! I'm so torn!! I'm pushing thru as long as I can taking it day by day and week by week!! Thanx for all the input!!

Re: Slow weight gain, need help!!

Like at the 20-25 min mark!

Letdowns happen throughout a feeding, typically.

I am not sure why you want to give up. If a formula fed baby were gaining poorly, and yes this certainly does happen, you would work to solve the problem- you could not very well 'give up' formula feeding. Right? It's the same with breastfeeding. If baby is not able to gain well breastfed, the issue is probably not with what baby is being fed. There is a problem and it is almost certainly solvable. What we are suggesting is it is not the quality of the milk into baby, it is the quantity-or there is another health issue causing poor gain. SOMETHING, whether it be that baby is not able to extract enough milk, or your supply needs increasing, or a separate health issue, is going on.

Again, I strongly suggest giving my ideas a try. And even if your baby does require some supplements, it would not be much at all to get weight gain up. Breastfeeding can and should certainly continue while baby gets supplements. Many times moms can supplement as much or almost as much needed with their own expressed milk.

Would you like help finding local support? Can you tell us where you live? You can PM me if you prefer.